The areola is the pigmented skin around the nipple. Areolae can be a variety of colors and sizes, ranging from light pinks to deep browns and every shade between. Some men and women are born with large or asymmetrical areolae. Others notice changes in the areola after pregnancy, breast feeding, or after dramatic changes in weight. An areola reduction can be performed to permanently change the size and shape of the areola.
- avg. recovery
About the Procedure
Commonly referred to as the nipple, the areola is actually a separate part of the breast that consists of the pigmented area around the nipple. Areolae are typically several shades darker than the surrounding skin but can be much darker, lighter, or the same color as the breast. Size and color of the areolae generally does not indicate any health concerns, as areolae can come in all shapes, sizes, and colors. For some, the areolae can be a cosmetic area of concern. Some men and women are born with areolae that are asymmetrical or are subjectively large. Areola characteristics can also be affected in adulthood by pregnancy, breastfeeding, and weight gain. For those who desire a change in the areola, a reduction procedure can be performed for permanent results. During the procedure the patient will be placed under local anesthesia, typically with a sedative as well. Patients who are combining an areola reduction with another procedure such as a breast augmentation, breast lift, or breast reduction, general anesthesia will likely be used. The patient will be marked preoperatively with 2 concentric circles around the areola. The inner circle will denote the new size of the areola. The outer circle will be made at the edges of the areola, with the area between the inner and outer circle representing the tissue that will be excised. If the patient would like the areola to sit at a higher position on the breast, more skin will be removed at the upper portion of the areola instead of removing an even amount of tissue around the nipple. The skin around the areola will then be infiltrated with a local anesthetic. Incisions will be made as per the preoperative markings and the excess tissue will be undermined and removed. Next, the wound will be closed, typically with a dissolvable circular stitch that closes with a “purse string” effect. It is common for additional permanent stitches to be placed to reduce tension and future stretching of the areola. The nipple will then be covered with a simple dressing. Most patients return to work within 1-2 days of the procedure and should avoid strenuous or sexual activities for 7-10 days.
The goal of an areola reduction is to reduce the size of the areola to be more symmetrical and aesthetically pleasing to the patient.
What to Expect
An areola reduction can be performed to permanently change the size and shape of the areola. Here is a quick guide for what to expect before, during, and after an areola reduction.
- Stop taking blood thinning medications 2 weeks before the procedure
- Stop smoking 4 weeks before and after surgery
- No alcohol 2 days prior
- Do not eat or drink anything 6 hours prior
- Preoperative markings to indicate new areola size
- Local anesthesia
- Incisions made around areola
- Excess tissue undermined and removed
- Dissolvable sutures to close
- Extra permanent stitch made to prevent tension
- Protective dressing applied
It is common to experience bruising and swelling after an areola reduction however most patients return to work after 1-2 days. Avoid strenuous and sexual activity for 7-10 days. Chest contact should be avoided for 3-4 weeks. Recovery will be longer if the procedure was combined with additional surgeries.
The ideal candidate for an areola reduction is self conscious about the size and/or shape of the pigmented area around the nipples.
Not Recommended For
Areola reduction is not recommended for patients who are pregnant or breastfeeding.
Side effects from areola reduction may include infection, asymmetry, loss of sensation either temporary or permanent, heightened sensitivity, numbness, loss of pigment, and visible scarring.